Seriously disabled users, e.g. persons with cerebral paresis, persons with traffic injuries or persons suffering from neurological diseases (e.g. Parkinson's disease) or muscular diseases (muscular dystrophy, coordination failures etc.) with limited control of their legs, experience difficulties in moving in such a way that involves use of the legs as well as experience problems with the coordination that is required to direct the body to a standing or walking attitude. Also, such individuals who for a prolonged amount of time are in a sleeping or sitting position due to muscular limitations or other functional failure, may obtain inter alia atrophy in muscles and limbs. When the muscles lose the possibility of active use with stretching, and at the same time lacking sensibility, there is a risk of damage to the nervous system, and it will finally lead to the muscles developing atrophy. In the absence of physical training, these individuals will not only be subject to more progressive muscular weakening, but also get aggravated health because of poor blood circulation, which again gives arise to a number of secondary effects, such as an increased tendency of blood thrombosis, wounds in the skin due to reduced blood supply to surface tissue, impairment of the heart etc.
The therapeutical methods for helping and assisting in movement of the limbs for such disabled persons are today comprised of exercising by stretching, which is often carried out with the aid of a therapist. These methods generally comprise different mechanical supports for helping the patient into a position which is more or less vertically upright. Leg movements will then be made with the aid of the therapist. Such methods are useful, but have a number of inherent limitations. Primarily, these methods are labour intensive and require continuous supervision and help from at least one, and often several therapists. Further, many of these methods and devices will not be helpful in a movement which gives a repetitive and continuously coordinated muscular movement and do not contribute to the disabled following the most desirable movement for the effective training of these bodily parts. The most favourable motion patterns for the training of nerves and muscles are such motions which occur for healthy persons, because muscles, the skeleton and neurological pathways are arranged for carrying out such movements. Training of isolated muscle groups may in many cases help a patient locally but complex movements, such as erection of the body and walking, will assist and train the disabled in a far more efficient way than local stimulation of isolated muscles or muscular groups.
Moreover, most training methods and/or devices will require interaction between the patient and the therapist. Generally the patient will have to be present at a hospital or a special training centre in order to make it possible to have help from the therapists to carry out the training exercises. It is desirable to have an apparatus which can be placed at home, and which can be handled either alone or with for example other family members, in addition to being used in a nursing situation at for example a nursing centre or a hospital.
It is thus known from US Patent Application 2002/0010056 a treadmill, in which a nurse assists a disabled person in walking, where the nurse is connected to a device and the nurse's leg movements are transferred to the disabled person (who is placed in a supporting strap).
From U.S. Pat. No. 6,440,046 is known a chair device for straightening up the back of disabled persons from a seated position, but where the disabled, after being brought to a standing position, then stands still without movement of the legs.
From JP Patent Application 2002382553 is known a device which may help patients who are not able to take an upright position to move the legs. Such a device is, however, like the other above-mentioned devices, run by the muscular power of the patient himself, and the patient must therefore use his own muscles in order to move the device. In particular cases, in which the present invention is directed towards, the individual is not capable of carrying out the relevant movements, either because coordination is not present (Parkinson's disease, cerebral paresis) or because the muscles cannot be activated by will (spinal injury).
Consequently there is a need for a compact type of apparatus which brings the persons up into desirable training positions, with the least possible help from others. This type of apparatus will preferably also have the feature of providing all natural movements and support for the legs and body in the required positions and training exercises. There is also a need for such an apparatus which is activated by the aid of an external power source, such as a motor, e.g. an electromotor, such that the motor movements of the patient are actively assisted.
For persons who have somewhat advanced in a training programme or treatment, it can be useful to avoid an external power source, so that the patient may increasingly use his own muscles to move the device. It is also required, for persons who are not able to do movements on their own, a machine which is motor driven and which performs the relevant walking movements forced onto the patient.
Various training equipment has been designed in order to make it easier with different movement training. Examples comprise treadmills which make it possible to walk or run on the spot; stepping machines which make it possible to climb or have step movements on the spot; bicycles which make it possible with cycle movements on the spot; and other apparatus which make it possible to skate or walk with skiing movements on the spot. Another type of apparatus makes possible somewhat more complicated movements and simulates more realistic walking movement, for instance apparatus with an elliptic movement. Training equipment has, however, the contrivance that they shall train persons who are already able (training muscular power, stamina, muscular tones, etc.) and are not arranged to be used on individuals who start from the point where they cannot perform the required movements at all, or can only perform parts of such complicated movements, or do not have the sufficient strength for such movements, even though the nerve impulses to the muscles are functioning normally. The actual movement patterns in such apparatus are however intended for natural movement of legs and body, but are not suitable for patients who are disabled.
With “abled” is meant, in this context, movement of a limb (the legs) which is carried out with the aid of normal nerve signals emitted from the brain, and which work on muscles moving the skeleton, where the muscles have sufficient strength (have sufficient muscular mass) to move by will the relevant limb, as well as possibly to hold the person upright.
An advantage of a training exercise with elliptical movement is that the user's foot is going up and down, as well as back and forth during a training cycle. Additionally, it is a purpose with the device, according to the present invention, preferably to provide as natural a walking movement for the legs as possible. As mentioned above, it is also one of the many purposes of the present invention to provide various movement patterns for the legs. Further, it is one of the many purposes of the present invention to provide the possibility of gradual adaptation of the relevant movement patterns by being able to vary the movement strokes for the relevant movements from a relatively small stroke to a natural stroke. This is an advantage, since new movements for disabled can be connected with anxiety and mental dislike, and gradual adaptation will then be advantageous.